SCREENING FOR THE PRESENCE OF A DISEASE BY POOLING SERA SAMPLES
SCREENING FOR THE PRESENCE OF A DISEASE BY POOLING SERA SAMPLES
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DOI：
10.2307/2290842
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发表时间：
1994-06-01
影响因子：
3.7
通讯作者：
PAGANO, M
中科院分区：
文献类型：
--
作者：
LITVAK, E;TU, XM;PAGANO, M
在第二次世界大战期间，建议对合并尿液样本进行筛查，作为降低美国士兵梅毒检测成本的方法。最近，汇集已被用于筛选人类免疫缺陷病毒（艾滋病毒）抗体，以帮助遏制病毒的进一步传播。合并降低了成本，但也可能更重要的是，提供了一种可行的方法，以降低在筛查低风险HIV人群时与标记样本相关的错误率。例如，考虑到目前可用的检测试剂盒的有限精确度，当筛查人群的患病率为4/1，000（这大致是估计的美国患病率）时，标记为阳性的样本不含抗体的概率可以从约90%（如果每个样本单独检测）降至约2%。此外，筛选合并的血清样品也可用于降低标记为阴性的样品实际上在这样的人群中具有高达40倍的抗体的可能性-当试图保持血液供应的完整性时，这是一个重要的考虑。在这篇文章中，我们概括了一些常用的池化过程，并介绍了一些新的。我们讨论和比较这些程序的相对优点和缺点，在实际情况下，在艾滋病毒筛查的背景下。所提出的程序也可以使用和推广到其他医疗和质量控制应用。
Screening of pooled urine samples was suggested during the Second World War as a method for reducing the cost of detecting syphilis in U.S. soldiers. Recently, pooling has been used in screening for human immunodeficiency virus (HIV) antibody to help curb the further spread of the virus. Pooling reduces the cost but also-and probably more importantly-offers a feasible way to lower the error rates associated with labeling samples when screening low-risk HIV populations. For example, given the limited precision of the presently available test kits, when the screened population has a prevalence of 4 per 1,000 (which is roughly the estimated U.S. prevalence), the probability that a sample labeled positive is antibody-free can be reduced from approximately 90% (if each sample is tested individually) to about 2%. Furthermore, screening pooled sera samples can also be used to reduce the probability that a sample labeled negative in fact has antibodies up to 40-fold in such a population-an important consideration when attempting to preserve the integrity of the blood supply. In this article we generalize some commonly used pooling procedures and introduce some new ones. We discuss and compare these procedures' relative merits and weaknesses under practical situations in the context of HIV screening. The proposed procedures can also be used and generalized to other medical and quality control applications.